Circadian Rhythms of Melatonin, Prolactin, Growth Hormone and Cortisol in Patients with Pituitary Adenomas, Empty Sella Syndrome and Cushing's Syndrome due to Adrenal Tumours

1981 ◽  
pp. 357-363 ◽  
Author(s):  
S. Werner ◽  
K. Brismar ◽  
L. Wetterberg ◽  
P. Eneroth
Keyword(s):  
Growth Hormone ◽  
Circadian Rhythms ◽  
Cushing’S Syndrome ◽  
Pituitary Adenomas ◽  
Cushing's Syndrome ◽  
Empty Sella ◽  
Empty Sella Syndrome ◽  
Adrenal Tumours

Chronobiological aspects of headache syndromes due to sellar or pituitary pathology

Cephalalgia ◽  
1983 ◽  
Vol 3 (1_suppl) ◽  
pp. 117-121
Author(s):  
Pierangelo Bossolo ◽  
Claudio Canepari ◽  
Mimma Maria Daguati ◽  
Alberto Cozzi ◽  
Marisa Fioravanti ◽  
...  
Keyword(s):  
Circadian Rhythms ◽  
Pituitary Adenomas ◽  
Pituitary Tumors ◽  
Empty Sella ◽  
Circadian Rhythmicity ◽  
Circadian Pattern ◽  
Empty Sella Syndrome ◽  
Before And After ◽  
Transsphenoidal Adenomectomy ◽  
Adenoma Ipofisario

A chronobiological study was carried out in headache syndromes due to empty sella or to pituitary G.H.- and PRL-secreting adenomas. In the empty sella syndrome only the chrono-organization of G.H. secretion was disturbed, whereas pl. PRL exhibited the usual circadian pattern. The circadian rhythms of pl. G.H. and pl. PRL were abolished in G.H.-and PRL-secreting pituitary tumors, respectively, and were again detectable when patients were cured by selective transsphenoidal adenomectomy. A normal circadian rhythmicity of pl. cortisol was demonstrable in the empty sella syndrome and in pituitary adenomas, both before and after surgery. On a étudié les aspects rhythmométriques de certains cas de céphalée secondaire à un atteinte sellaire ou bien hypophysaire, tels la syndrome de la selle vide et les adénomes GH- ou PRL-secrétants. Au cours du syndrome de la selle vide on observe un trouble de la rhythmicité circadienne du GHpl., tandis que les autres rhythmes (PRL et cortisol pl., température orale) sont normaux. Dans les adénomes GH- ou PRL-secrétants on observe une altération sélective du rhythme circadien de l'hormone spécifiquement secrétée par l'adénome. Après l'exérèse chirurgicale de l'adénome par voie transphénoidale, la normalization des niveaux plasmatiques hormonaux s'accompagne à la réapparition du rhythme circadien habituel. Le rhythme circadien du cortisol plasmatique ne semble pas être affecté par la présence d'une selle vide ou bien d'un adénome GH- ou PRL-secrétant ni par l'adenomectomie par voie transphénoidale. E’ stata attuata una indagine cronobiologica in corso di cefalea secondaria a patologie sellario ipofisarie, quali la sindrome della sella vuota e gli adenomi GH- o PRL-secernenti, con sindrome cefalalgica. In presenza di empty sella si riscontra un'alterazione della cronoorganizzazione circadiana solo per la secrezione di G.H., mentre la PRL pl. presenta il normale ritmo circadiano. Negli adenomi ipofisari si rileva la scomparsa della normale ritmicità circadiana dell'ormone specificamente ipersecreto e la completa rimozione dell'adenoma per via trans-nasosfenoidale è seguita dal ripristino del ritmo circadiano dell'ormone stesso. Il ritmo circadiano del cortisolo pl. non risulta alterato nell'empty sella nè in presenza di adenoma ipofisario GH o PRL-secernente e non viene significativamente modificato dall'intervento neurochirurgico.

Gastrin in pituitary tumours

1987 ◽  
Vol 115 (3) ◽  
pp. 419-422 ◽  
Author(s):  
Linda Bardram ◽  
Jörgen Lindholm ◽  
Jens F. Rehfeld
Keyword(s):  
Cushing’S Syndrome ◽  
Pituitary Adenomas ◽  
Cushing's Syndrome ◽  
Pituitary Tumours ◽  
Nelson’S Syndrome ◽  
Nelson's Syndrome

Abstract. Twelve of 87 pituitary adenomas from patients with acromegaly, Cushing's syndrome, Nelson's syndrome, hyperprolactinaemia and without symptoms of hormone hypersecretion contained gastrin in concentrations from 0.5 to 166 pmol/g. Only ACTH-producing tumours contained gastrin, which occurred in forms smaller than those present in the normal adenohypophysis. The results indicate that corticotropic tumours may synthesize gastrin in moderate amounts.

scholarly journals Surgical Management of Giant Pituitary Adenomas

1990 ◽  
Vol 17 (1) ◽  
pp. 62-66 ◽  
Author(s):  
Gérard Mohr ◽  
Jules Hardy ◽  
Ronald Comtois ◽  
Hughes Beauregard
Keyword(s):  
Pituitary Adenomas ◽  
Residual Tumor ◽  
Empty Sella ◽  
Csf Leak ◽  
Visual Field Defects ◽  
Pituitary Insufficiency ◽  
Empty Sella Syndrome ◽  
Type D ◽  
Giant Pituitary Adenomas ◽  
Type C

ABSTRACT:During the past 25 years, 77 giant pituitary adenomas have been treated surgically, including suprasellar extensions of type C in 66 cases and of type D in 11 cases. Non-secreting adenomas were present in 53 and secreting adenomas in 24 cases. All patients except 3 presented with significant visual field defects; including bitemporal hemianopia, superior quadranopia or unilateral temporal hemianopia, contralateral blindness in 73% of the cases, and one case with sudden bilateral blindness due to acute pituitary apoplexy. A single transsphenoidal procedure was carried out in 74% of the patients while 11 patients (7%) required re-operations for recurrent or residual tumor. Only 3 patients required a subsequent transcranial procedure. Complications included 1 CSF-leak, 1 empty-sella syndrome and 4 fatal post-operative hematomas. We prefer the transsphenoidal route even in very large or giant pituitary adenomas, since it allows rapid and adequate decompression of the optic nerves and chiasm, avoids major pituitary insufficiency in 60% of the cases and is associated with low morbidity-mortality rates.

scholarly journals Dopamine agonist-responsive Cushing’s disease

2019 ◽  
Vol 12 (2) ◽  
pp. bcr-2018-228045
Author(s):  
Gurpreet Anand ◽  
Andrea Bink ◽  
Felix Beuschlein ◽  
Christoph Schmid
Keyword(s):  
Growth Hormone ◽  
Dopamine Agonist ◽  
Cushing’S Syndrome ◽  
Tumour Size ◽  
Hypogonadotropic Hypogonadism ◽  
Immunohistochemical Analysis ◽  
Cushing's Syndrome ◽  
Central Hypothyroidism ◽  
Mri Scans

A 47-year-old Caucasian man was referred to our clinic with a severe clinical and biochemical phenotype of endogenous hypercortisolism for further evaluation and treatment. In addition to confirming adrenocorticotropic hormone (ACTH)-dependent Cushing’s syndrome, we found left temporal hemianopsia, massively increased prolactin, increased growth hormone/insulin-like growth factor 1 values, hypogonadotropic hypogonadism and central hypothyroidism. As the cause of these abnormalities we revealed an invasive macroadenoma of the pituitary secreting ACTH, prolactin and growth hormone, resulting not only in a clinically predominant picture of Cushing’s syndrome but also causing hypogonadotropic hypogonadism and central hypothyroidism. The patient responded surprisingly well to dopamine agonist treatment leading not only to normalisation of prolactin levels but also to clinical and biochemical remission of Cushing’s syndrome. Tumour size decreased successively in follow-up MRI scans. Despite lacking immunohistochemical analysis of tumour tissue, we assume plurihormonal secretion of ACTH, prolactin and growth hormone from pituitary macroadenoma, which fortunately responded well to dopamine agonist treatment.

Neurosurgical implications of Carney complex

2000 ◽  
Vol 92 (3) ◽  
pp. 413-418 ◽  
Author(s):  
Joe C. Watson ◽  
Constantine A. Stratakis ◽  
Peter K. Bryant-Greenwood ◽  
Christian A. Koch ◽  
Lawrence S. Kirschner ◽  
...  
Keyword(s):  
Cushing’S Syndrome ◽  
Pituitary Adenomas ◽  
Carney Complex ◽  
Cushing's Syndrome ◽  
Spinal Tumors ◽  
Common Component ◽  
Content Type ◽  
Cardiac Myxomas ◽  
Insight Into ◽  
Fine Print

Object. The authors present their neurosurgical experience with Carney complex. Carney complex, characterized by spotty skin pigmentation, cardiac myxomas, primary pigmented nodular adrenocortical disease, pituitary tumors, and nerve sheath tumors (NSTs), is a recently described, rare, autosomal-dominant familial syndrome that is relatively unknown to neurosurgeons. Neurosurgery is required to treat pituitary adenomas and a rare NST, the psammomatous melanotic schwannoma (PMS), in patients with Carney complex. Cushing's syndrome, a common component of the complex, is caused by primary pigmented nodular adrenocortical disease and is not secondary to an adrenocorticotropic hormone-secreting pituitary adenoma.Methods. The authors reviewed 14 cases of Carney complex, five from the literature and nine from their own experience. Of the 14 pituitary adenomas recognized in association with Carney complex, 12 developed growth hormone (GH) hypersecretion (producing gigantism in two patients and acromegaly in 10), and results of immunohistochemical studies in one of the other two were positive for GH. The association of PMSs with Carney complex was established in 1990. Of the reported tumors, 28% were associated with spinal nerve sheaths. The spinal tumors occurred in adults (mean age 32 years, range 18–49 years) who presented with pain and radiculopathy. These NSTs may be malignant (10%) and, as with the cardiac myxomas, are associated with significant rates of morbidity and mortality.Conclusions. Because of the surgical comorbidity associated with cardiac myxoma and/or Cushing's syndrome, recognition of Carney complex has important implications for perisurgical patient management and family screening. Study of the genetics of Carney complex and of the biological abnormalities associated with the tumors may provide insight into the general pathobiological abnormalities associated with the tumors may provide insight into the general pathobiological features of pituitary adenomas and NSTs.

PARTIAL SOMATOTROPHIN INSUFFICIENCY IN CUSHING'S SYNDROME

1969 ◽  
Vol 60 (1) ◽  
pp. 121-129 ◽  
Author(s):  
G. Strauch ◽  
E. Modigliani ◽  
P. Luton ◽  
H. Bricaire
Keyword(s):  
Growth Hormone ◽  
Cushing’S Syndrome ◽  
Selective Inhibition ◽  
Cushing's Syndrome ◽  
Glucose Load ◽  
Plasma Growth Hormone ◽  
Arginine Infusion ◽  
Hormone Levels

ABSTRACT Plasma growth hormone levels were studied in 15 patients with Cushing's syndrome using several stimuli. All tests except one, were performed before treatment. No change occurred in 6 patients during acute hypoglycaemia and in 11 out of 13 after a glucose load. Arginine given intravenously to 11 subjects elicited a rise in 7 out of 8 females and 1 out of 3 males. From patients who responded to arginine infusion, 6 were insensitive to one or two of the above mentioned stimuli. A selective inhibition of the releasing mechanisms might account for the partial somatotrophin insufficiency found in Cushing's syndrome.

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